Kids' Camp at DUMC *Registration*
June 24 - 27, 2024 9am to Noon $50 per child
Sign up to volunteer that week at the end of this form!
Student #1
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Grade Level
*
3 and fully potty trained
4 years old
Upcoming kindergarten
Upcoming 1st grade
Upcoming 2nd grade
Upcoming 3rd grade
Upcoming 4th grade
Upcoming 5th grade
Student #1: Allergies or medical conditions that we need to know about.
Student #2
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Gender
Male
Female
Grade Level
3 and fully potty trained
4 years old
Upcoming kindergarten
Upcoming 1st grade
Upcoming 2nd grade
Upcoming 3rd grade
Upcoming 4th grade
Upcoming 5th grade
Student #2: Allergies or medical conditions that we need to know about.
Student #3
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Gender
Male
Female
Grade Level
3 and fully potty trained
4 years old
Upcoming kindergarten
Upcoming 1st grade
Upcoming 2nd grade
Upcoming 3rd grade
Upcoming 4th grade
Upcoming 5th grade
Student #3: Allergies or medical conditions that we need to know about.
Parent/Guardian Information
Parent Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter the best number to reach you during Kids' Camp hours.
Emergency contact or authorized person who can pickup the child(ren) on dismissal
*
First & Last Name
Cell number
Agreement
I allow my child to participate in Kids' Camp at Dacula UMC.
All fees are non-refundable.
I authorize the church staff or camp adult volunteers to administer first aid, and medical care in the event of an emergency situation. I agree to pay for all the medical care expenses and costs in a given situation that emergency medical care is needed.
I release Dacula UMC from any liabilities that might happen during the activity and hold them harmless in the event of damages, injuries, or accidents.
I confirm that all information in this form is accurate and true to the best of my knowledge.
We will be taking photos and videos of the participants during the Kids' Camp at DUMC, which may be used in our worship services or on our church social media.
*
Yes, I understand
Type in your name or initials as your signature.
Date Signed
*
-
Month
-
Day
Year
Date
I can volunteer at Kids' Camp the week of June 24-27 from 9am to noon!
We especially need adults to lead/teach classes, 2 adults at the First Aid station, and youth in all areas!
Name
First Name
Last Name
I am a: *A background check will be performed on all adults age 18+.
Please Select
Adult
Youth (6th - 12th grade)
College student
I would like to volunteer as:
Lead teacher (adult)
Assistant teacher
Outside games
Snacks/Carpool
Music
First Aid Station (adult)
Other
Submit
Should be Empty: